Genes and environment: multiple pathways to psychopathology.

摘要

In this issue of Biological Psychiatry, the work by van Uzendoom et al. (1) describes how the report of a previous abusive event in children adopted shortly after birth can result in unresolved grief or loss, depending on the serotonin-transporter (5HTT) gene promoter region polymorphism and DNA methylation levels of an associated CpG island. This study attempts to determine whether genetic and epigenetic factors can contribute to increased vulnerability to loss and attachment-related trauma. Clinical studies have found that reported childhood adversity such as physical or sexual abuse or deprivation are risk factors for psychopathology in later childhood and adulthood. Examples of such psychopathology include mood disorders, anxiety disorders, and suicide. At the same time there is evidence that these disorders are heritable, although the identities of the genes involved in the etiology of such psychopathology have remained elusive. Not all those exposed to adversity during childhood manifest psychopathology later in life, indicating the existence of a diathesis in some but not all individuals. Studies have shown that the risk of psychopathology in those with a reported history of childhood adversity is affected by genotype (2).